Distribution of body mass index among subjects with COPD in the Middle East and North Africa region: data from the BREATHE study

Abstract

Background: Data describing the potential relationship between chronic obstructive pulmonary disease (COPD) and body mass index (BMI) are limited within the Middle East and North Africa (MENA) region.

Objective: To evaluate the distribution of BMI among subjects with COPD in the general population of the MENA region.

Methods: This study was a subanalysis of the BREATHE study, a cross-sectional survey of COPD conducted in the general population of ten countries in the MENA region and Pakistan. The study population consisted of subjects screened for COPD who documented their weight and height. A COPD questionnaire was administered to subjects who screened positively for COPD in order to collect data on patient characteristics, symptom severity, management and burden of disease, comorbidities, and health care resource utilization and data allowing calculation of the BMI. The COPD Assessment Test (CAT) was administered to those screened positively for COPD to collect data on the impact of respiratory symptoms.

Results: Nine hundred and ninety-six subjects with COPD, who completed the detailed COPD questionnaire and documented their weight and height, were included in this analysis. The mean BMI was 27.7±5.7 kg/m(2). The proportion of COPD patients with a BMI ≥25 kg/m(2) is significantly higher than the proportion with a BMI <25 kg/m(2) (64.6% [n=643] vs 35.4% [n=353], respectively; P<0.0001). There were no significant differences between the distribution of BMI, ages, sex, COPD symptoms, exacerbations, CAT scores, COPD-associated health care resource consumption, and GOLD severity groups. However, the occurrence of comorbidities such as diabetes and cardiovascular diseases seemed to be significantly associated with obese or morbidly obese status (P=0.02).

Conclusion: In the MENA region, the majority of COPD subjects were overweight or obese, and comorbidities such as diabetes or cardiovascular diseases are likely to be associated with COPD when BMI is in the obese or morbidly obese ranges.

Keywords: BMI; COPD; MENA region; association.

Figure 1

Disposition of the study population. Notes: *COPD subjects fulfilling the COPD epidemiological definition used in the study. Proportions are calculated for each population with respect to the previous line. Abbreviation: COPD, chronic obstructive pulmonary disease.

Figure 2

Distribution of BMI in COPD population.

Figure 3

Distribution of BMI in COPD population according to each participant country. Green bars: underweight (BMI <20 kg/m²); blue bars: normal weight (BMI 20–25 kg/m²); yellow bars: overweight (BMI 25–30 kg/m²); orange bars: obese (BMI 30–35 kg/m²); red bars: morbidly obese (BMI ≥35 kg/m²). The mean BMI (± SD) is provided above the histograms for each country. Abbreviations: BMI, body mass index; COPD, chronic obstructive pulmonary disease; SD, standard deviation.

Figure 4

Variables associated with CAT scores identified by multiple logistic regression analysis. Note: Data are presented as Forest diagrams showing odds ratios with 95% confidence intervals. Abbreviation: CAT, COPD Assessment Test.